MEDICARE: NEAL JAY KATZ D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	424-025	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3886620001	OTHER	WI	MEDICARE DMEPOS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	406075	OTHER	WI	DEAN HEALTH PLAN

General Provider Information

NPI Number	:	1104878750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEAL JAY KATZ D.P.M.

Provider Business Mailing Address
First Line	:	4033 COUNTY ROAD JJ
Second Line	:
City	:	BLACK EARTH
State	:	WI
Zip	:	53515-9729
Country	:	US
Telephone Number	:	608-225-1529
Fax Number	:

Provider Business Practice Location Address
First Line	:	664 W WASHINGTON AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53703-2638
Country	:	US
Telephone Number	:	608-241-0848
Fax Number	:	608-767-2015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	10/29/2014

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